Limited evidence for effectiveness of H1-antihistamines for chronic spontaneous urticaria

For general use, cetirizine 10mg once daily for short-term (up to 2 weeks) and intermediate-term (up to 3 months) duration was effective in completely suppressing urticaria, although not in all individuals. Some benefit might be associated with the use of desloratadine 5mg daily for at least an intermediate term, and at 20mg daily in the short term. Levocetirizine 5mg daily was effective for complete suppression in the intermediate term but not in the short term. A higher dose of 20mg daily was effective in the short term, but 10mg daily was not. Adverse events, such as headache or dry mouth, were tolerable with most antihistamines. Evidence was less clear for improvement in quality of life (eg, reduction in sleep disturbance from itching, less distress from the appearance of hives), as many studies did not address this. It was not possible to say whether one antihistamine worked better than all the rest, as there was not head-to-head evidence for every possible treatment comparison.